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QTc Interval Prolongation and Stroke: Any Differences between Ischemic and Hemorrhagic Strokes?

Year 2014, Volume: 39 Issue: 1, 75 - 82, 22.07.2014
https://doi.org/10.17826/cutf.67051

Abstract

Purpose: Strokes results in a multitude of electrocardiographic (ECG) changes, and a prolongation of the QTc interval is a well-observed one. We analyzed QTc interval prolongation among males and females who presented with acute stroke. Material and Methods: This observational study was conducted at the department of neurology of the Sulaimaniya general teaching hospital, from August 2012 to May 2013, and involved 100 consecutive patients who presented with acute stroke; 50 had ischemic stroke and the rest (n=50) had hypertensive intracerebral hemorrhage. All patients underwent resting 12-lead ECG within half an hour of A&E admission. The QTc interval was calculated and analyzed. A comparison among males and females in both stroke types was done. Results: The ischemic group had 25 males and 25 females; 25 patients (25%; 13 males and 12 females) demonstrated QTc interval prolongation. Thirty two males and 18 females constituted the hemorrhagic group; QTc interval prolongation was observed in 18 males and 8 females (n=26; 26%). There was no statistically significant difference in the QTc interval prolongation among males of the ischemic stroke versus hemorrhagic group (P-value

References

  • Goldstein DS. The electrocardiogram in stroke: relationship to pathophysiological type and comparison with prior tracings. Stroke. 1979;10:253
  • Khechinashvili G, Asplund K. Electrocardiographic changes in patients with acute stroke: a systematic review. Cerebrovasc Dis. 2002;14:67-76.
  • Oppenheimer SM, Hachinski VC. The cardiac consequences of stroke. Neurol Clin. 1992;10:167
  • Golan S, Livneh A. ECG changes during stroke. Harefuah 2008;147:568-9, 572.
  • Oppenheimer SM, Cechetto DF, Hachinski VC. Cerebrogenic cardiac arrhythmias. Cerebral electrocardiographic influences and their role in sudden death. Arch Neurol. 1990;47:513-9.
  • Cheung RT, Hachinski V. The insula and cerebrogenic sudden death. Arch Neurol 2000;57:1685-8.
  • Adams HP Jr, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007;38:1655-711.
  • Broderick JP, Adams HP Jr, Barsan W, Feinberg W, Feldmann E, Grotta J, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 1999;30:905-15.
  • Amin OSM, Shwani SS, Noori SF, Hasan AM. Carbamazepine and the QTc interval; any association? Neurology Asia. 2010;15:119-23
  • Cowan JC, Yusoff K, Moore M, Amos PA, Gold AE, Bourke JP, et al. Importance of lead selection in QT interval measurement. Am J Cardiol. 1988;61:83-7.
  • Hnatkova K, Malik M. “Optimum” formulae for heart rate correction of the QT interval. Pacing Clin Electrophysiol. 1999;22:1683-7.
  • Kligfi eld P, Hancock EW, Helfenbein ED, et al. Relation of QT interval measurements to evolving automated algorithms from different manufacturers of electrocardiographs. Am J Cardiol. 2006;98:88-92.
  • Akbar MA, Haider SA, Awan MM, Choudhry GM. Stroke; electrocardiographic changes. Professional Med J. 2008;15:91-5.
  • Arab D, Yahia AM, Qureshi AI. Cardiovascular manifestations of acute intracranial lesions: Pathophysiology, manifestations, and treatment. J Intensive Care Med. 2003;18:119-29..
  • El Haddad B, Abou Jaoude D, Hammoud D. Cardiac complications of acute stroke. Kansas Journal of Medicine. 2011;4:37-40.
  • Bayer E, Ashman R, Toth LA. Electrocardiogram with large upright T wave and long Q-T intervals. Am Heart J. 1947;33:796-801.
  • Connor R. Myocardial damage secondary to brain lesions. Am Heart J. 1969;78:145-8.
  • Suffer J, Dreifus LS, Michelson E. Polymorphous ventricular tachycardia associated with normal and long QT intervals. Am J Cordiol. 1982;49:2021-9.
  • Wong KS. Risk factors for early death in acute ischemic stroke and intracerebral hemorrhage. A prospective hospital based study in Asia. Asian Acute Stroke Advisory Panel. Stroke. 1999;30:2326-30.
  • Klingelhofer J, Sander D. Cardiovascular consequences of clinical stroke. Baillieres Clin Neurol. 1997;6:309-35.
  • Soliman EZ, Howard G, Cushman M, Kissela B, Kleindorfer D, Le A, et al. Prolongation of QTc and risk of stroke: The REGARDS (REasons for Geographic and Racial Differences in Stroke) study. J Am Coll Cardiol. 2012;59:1460-7.
  • Maebuchi D, Arima H, Doi Y, Ninomiya T, Yonemoto K, Tanizaki Y, et al. QT interval prolongation and the risks of stroke and coronary heart disease in a general Japanese population: the Hisayama study. Hypertens Res. 2010;33:916-21.
  • Lavy S, Yaar I, Melamed E, Stern S. The effect of acute stroke on cardiac function as observed in an intensive stroke care unit. Stroke. 1974;5:775-780.
  • Yazışma Adresi / Address for Correspondence: Osama Shukir Muhammed Amin Sulaimaniya City Post-Office, PO BOX 196, Sulaimaniya City, IRAQ E-mail: dr.osama.amin@gmail.com geliş tarihi/received :28.08.2012 kabul tarihi/accepted:25.09.2012

QTc Aralığı Uzaması ve İnme: İskemik ve Hemorajik İnme Arasındaki Farklar

Year 2014, Volume: 39 Issue: 1, 75 - 82, 22.07.2014
https://doi.org/10.17826/cutf.67051

Abstract

Amaç: İnmeler genellikle çok sayıda elektrokardiyografi (EKG) değişiklikleri ve QTc aralığının uzaması ile karakterizedir. Çalışmamızda akut inme ile başvuran kadın ve erkek hastaların QTc aralığını analiz ettik. Materyal ve Metod: Bu gözlemsel çalışmada Ağustos 2012"den Mayıs 2013'e, Süleymaniye genel eğitim hastanesinin nöroloji bölümünde akut inme ile başvuran 100 hasta dahil edildi; 50 iskemik inme ve 50 intraserebral hipertansif kanamalı. Tüm hastalara A&E kabulünü müteakip yarım saat içirisinde dinlenme durumunda EKG yapıldı. QTc aralığı hesaplanıp analiz edildi. Her iki inme tipinde de kadınlar ve erkekler arasında bir karşılaştırma yapıldı. Bulgular: İskemik grubunda 25 erkek ve 25 kadın vardı, 25 hastada (% 25, 13 erkek ve 12 kadın) QTc aralığı uzaması saptandı. Otuz iki erkek ve 18 kadın hemorajik grubu oluşturdu; QTc aralığı uzaması 18 erkek ve 8 kadında gözlendi (n = 26;% 26). QTc aralığı uzaması açısından hemorajik grup erkekler iskemik inmesi olan erkekler ile karşılaştırıldığında (P-değeri

References

  • Goldstein DS. The electrocardiogram in stroke: relationship to pathophysiological type and comparison with prior tracings. Stroke. 1979;10:253
  • Khechinashvili G, Asplund K. Electrocardiographic changes in patients with acute stroke: a systematic review. Cerebrovasc Dis. 2002;14:67-76.
  • Oppenheimer SM, Hachinski VC. The cardiac consequences of stroke. Neurol Clin. 1992;10:167
  • Golan S, Livneh A. ECG changes during stroke. Harefuah 2008;147:568-9, 572.
  • Oppenheimer SM, Cechetto DF, Hachinski VC. Cerebrogenic cardiac arrhythmias. Cerebral electrocardiographic influences and their role in sudden death. Arch Neurol. 1990;47:513-9.
  • Cheung RT, Hachinski V. The insula and cerebrogenic sudden death. Arch Neurol 2000;57:1685-8.
  • Adams HP Jr, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007;38:1655-711.
  • Broderick JP, Adams HP Jr, Barsan W, Feinberg W, Feldmann E, Grotta J, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 1999;30:905-15.
  • Amin OSM, Shwani SS, Noori SF, Hasan AM. Carbamazepine and the QTc interval; any association? Neurology Asia. 2010;15:119-23
  • Cowan JC, Yusoff K, Moore M, Amos PA, Gold AE, Bourke JP, et al. Importance of lead selection in QT interval measurement. Am J Cardiol. 1988;61:83-7.
  • Hnatkova K, Malik M. “Optimum” formulae for heart rate correction of the QT interval. Pacing Clin Electrophysiol. 1999;22:1683-7.
  • Kligfi eld P, Hancock EW, Helfenbein ED, et al. Relation of QT interval measurements to evolving automated algorithms from different manufacturers of electrocardiographs. Am J Cardiol. 2006;98:88-92.
  • Akbar MA, Haider SA, Awan MM, Choudhry GM. Stroke; electrocardiographic changes. Professional Med J. 2008;15:91-5.
  • Arab D, Yahia AM, Qureshi AI. Cardiovascular manifestations of acute intracranial lesions: Pathophysiology, manifestations, and treatment. J Intensive Care Med. 2003;18:119-29..
  • El Haddad B, Abou Jaoude D, Hammoud D. Cardiac complications of acute stroke. Kansas Journal of Medicine. 2011;4:37-40.
  • Bayer E, Ashman R, Toth LA. Electrocardiogram with large upright T wave and long Q-T intervals. Am Heart J. 1947;33:796-801.
  • Connor R. Myocardial damage secondary to brain lesions. Am Heart J. 1969;78:145-8.
  • Suffer J, Dreifus LS, Michelson E. Polymorphous ventricular tachycardia associated with normal and long QT intervals. Am J Cordiol. 1982;49:2021-9.
  • Wong KS. Risk factors for early death in acute ischemic stroke and intracerebral hemorrhage. A prospective hospital based study in Asia. Asian Acute Stroke Advisory Panel. Stroke. 1999;30:2326-30.
  • Klingelhofer J, Sander D. Cardiovascular consequences of clinical stroke. Baillieres Clin Neurol. 1997;6:309-35.
  • Soliman EZ, Howard G, Cushman M, Kissela B, Kleindorfer D, Le A, et al. Prolongation of QTc and risk of stroke: The REGARDS (REasons for Geographic and Racial Differences in Stroke) study. J Am Coll Cardiol. 2012;59:1460-7.
  • Maebuchi D, Arima H, Doi Y, Ninomiya T, Yonemoto K, Tanizaki Y, et al. QT interval prolongation and the risks of stroke and coronary heart disease in a general Japanese population: the Hisayama study. Hypertens Res. 2010;33:916-21.
  • Lavy S, Yaar I, Melamed E, Stern S. The effect of acute stroke on cardiac function as observed in an intensive stroke care unit. Stroke. 1974;5:775-780.
  • Yazışma Adresi / Address for Correspondence: Osama Shukir Muhammed Amin Sulaimaniya City Post-Office, PO BOX 196, Sulaimaniya City, IRAQ E-mail: dr.osama.amin@gmail.com geliş tarihi/received :28.08.2012 kabul tarihi/accepted:25.09.2012
There are 24 citations in total.

Details

Primary Language Turkish
Journal Section Research
Authors

Osama Shukir Muhammed Amin This is me

Hawar Adnan Myckan This is me

Emad Hama Hussein This is me

Publication Date July 22, 2014
Published in Issue Year 2014 Volume: 39 Issue: 1

Cite

MLA Amin, Osama Shukir Muhammed et al. “QTc Aralığı Uzaması Ve İnme: İskemik Ve Hemorajik İnme Arasındaki Farklar”. Cukurova Medical Journal, vol. 39, no. 1, 2014, pp. 75-82, doi:10.17826/cutf.67051.